Probiotics in antibiotic-associated diarrhoea.

Area of Science:

• Gastroenterology
• Microbiology

Background:

• Antibiotic-associated diarrhea (AAD) is a frequent complication of antibiotic use.
• Clostridium difficile colitis is a severe, distinct complication of antibiotic administration.
• Probiotic supplementation is a recognized treatment strategy for AAD and C. difficile colitis.

Purpose of the Study:

• To overview the therapeutic efficacy of various probiotics in managing antibiotic-associated diarrhea.
• To evaluate the scientific rationale and evidence supporting probiotic use for AAD.
• To identify potential areas for improving probiotic standardization and assessment.

Main Methods:

• Review of randomized, double-blind, controlled clinical trials (RCTs) for probiotic efficacy.
• Analysis of studies investigating specific probiotic strains, including Saccharomyces boulardii, Lactobacillus acidophilus, Lactobacillus bulgaricus, Lactobacillus rhamnosus GG, Bifidobacterium longum, and Enterococcus faecium SF68.
• Examination of methodologies, including assessment of bacterial recovery in stools.

Main Results:

• Three RCTs demonstrate the therapeutic effect of Saccharomyces boulardii in AAD.
• Two double-blind controlled studies confirm the efficacy of Lactobacillus acidophilus and Lactobacillus bulgaricus.
• Non-double-blind studies suggest benefits from Lactobacillus rhamnosus GG, Bifidobacterium longum, and Enterococcus faecium SF68 for AAD prevention.

Conclusions:

• Probiotic supplementation demonstrates a consistent scientific rationale for managing antibiotic-associated diarrhea.
• While efficacy is supported, few studies assess bacterial recovery in stools, highlighting a need for improved standardization.
• Further investigation into stool bacterial recovery could inform more rigorous probiotic dosage standards.